Advances in Interventional Cardiology
eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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3/2025
vol. 21
 
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abstract:
Original paper

Electromechanical demonstration of premature ventricular contraction-induced atrial cardiomyopathy by P wave duration-to-amplitude ratio (PWDAR) and left atrial strain

Mustafa Doğduş
1
,
Taha Okan
2
,
Ugur Taskin
1
,
Ganbar Mammadov
1
,
Bekir Akkaya
3
,
İlhan Koyuncu
4
,
Caner Topaloğlu
1

  1. Department of Cardiology, Faculty of Medicine, Medical Point Hospital, Izmir University of Economics, Izmir, Turkey
  2. Kardiya Medical Center, Izmir, Turkey
  3. Private Medical Park Izmir Hospital, Izmir, Turkey
  4. Department of Cardiology, Cigli Training and Research Hospital, Bakircay University, Izmir, Turkey
Adv Interv Cardiol 2025; 21, 3 (81): 394–401
DOI: https://doi.org/10.5114/aic.2025.154171
Online publish date: 2025/09/09
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Introduction:
High premature ventricular contraction (PVC) burden is known to cause atrial remodeling. P wave duration-to-amplitude ratio (PWDAR) is a new P wave index that includes both P wave duration and P wave voltage, which can be considered to effectively evaluate atrial cardiomyopathy. 3D speckle-tracking echocardiography is accepted as a valid and reliable technique for assessment of the left ventricle (LV) and left atrium (LA).

Aim:
In the present study, we investigated whether patients with a high PVC burden exhibit subclinical left atrial electrical and mechanical dysfunction, assessed electrically using PWDAR and mechanically using 3D-speckle tracking echocardiography.

Material and methods:
Seventy-five patients with PVC (PVC+) and 75 age- and gender-matched controls were enrolled in the study. Surface 12-lead standard electrocardiograms (ECGs) were recorded. Clinical characteristics and laboratory values of the patients were obtained. Conventional 2D echocardiographic and 3D-STE analyses were performed.

Results:
The PWDAR was significantly higher in the PVC+ group than in the control group (p < 0.001); and the LAS-r, LAS-active, and LV-GLS were significantly depressed in the PVC+ group (p < 0.001, p < 0.001, p = 0.015, respectively). The multivariate regression models demonstrated that PWDAR (p < 0.001), LAS-r (p < 0.001), LAS-active (p = 0.008), and LV-GLS (p = 0.021) were independent factors predicting PVC-induced atrial cardiomyopathy (PVC-ACMP).

Conclusions:
Our results revealed subclinical left atrial electrical and mechanical dysfunction in patients with a high PVC burden. PWDAR and left atrial strain parameters can predict PVC-ACMP.

keywords:

premature ventricular contraction, P wave duration, P wave amplitude, left atrial dysfunction, 3D speckle-tracking echocardiography
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